| IN RE: PAMELA K. MILLER | ) | DOCKET NO. 05 12252 |
| ) | ||
| CLAIM NO. W-529953 | ) | DECISION AND ORDER |
| ) |
APPEARANCES:
Claimant, Pamela K. Miller,
by
David B. Vail, Jennifer Cross-Euteneier & Associates,
per
Jennifer Cross-Euteneier
Self-Insured Employer, Tacoma School District #10, by
Thomas G. Hall & Associates, per
Thomas G. Hall and Joseph A. Albo
The claimant, Pamela K. Miller, filed an appeal with the Board
of Industrial Insurance Appeals on March 8, 2005, from an order of the
Department of Labor and Industries dated January 14, 2005. In this order, the Department determined that
it was unable to reconsider its order of March 18, 2004, due to lack of
jurisdiction. The Department order is REVERSED AND REMANDED.
DECISION
Pursuant to RCW 51.52.104 and RCW
51.52.106, this matter is before the Board for review and decision on a timely
Petition for Review filed by the claimant to a Proposed
Decision and Order issued on November 1, 2005, in which the industrial appeals judge dismissed Ms. Miller's appeal
from the January 14, 2005 Department order.
The
Board has reviewed the evidentiary rulings in the record of proceedings and
finds that no prejudicial error was committed and the rulings are
affirmed. We grant
review because we disagree with the industrial appeal judge's interpretation of
RCW 51.04.080 and its application to this case. We will briefly summarize the facts pertinent to deciding this matter.
Pamela
K. Miller filed an Application for Benefits under the Industrial Insurance Act
on May 18, 2000, for an injury that occurred on May 3, 2000. On May 3, 2000, Ms. Miller worked for Tacoma
School District #10, a self-insured employer. On October 19, 2000, the self-insured employer issued an order closing
the claim. According to the appeal
notice rights statement included with the order, Ms. Miller could not file an
appeal of the order with the Board of Industrial Insurance Appeals (Board), but
could appeal to the Department of Labor and Industries (Department). Ms. Miller did not appeal the closing order.
[2] On January 28, 2004, Ms. Miller
filed an aggravation application to reopen her claim. On January 29, 2004, the Law Office of David
B. Vail & Associates submitted Notices of Representation to the
self-insurance section of the Department and to the third-party administrator
for the self‑insured employer, Puget Sound Workers' Compensation
Trust. The Department received the
Notice of Representation on January 30, 2004, but returned it to Mr. Vail's
office on February 5, 2004. The
Department received Ms. Miller's application to reopen on February 6,
2004. Mr. Vail re‑mailed the
Notice of Representation on February 27, 2004. The Department received it on March 1, 2004.
On
March 18, 2004, the Department issued an order in which it denied Ms. Miller's
application to reopen her claim. In its
order the Department included the statutorily required notice of appeal rights. The Department did not send a copy of the
order to Mr. Vail's office. On July 27,
2004, the Department issued a letter wherein it acknowledged Mr. Vail's Notice
of Representation. On November 30, 2004,
Mr. Vail's office filed a formal protest of the Department's March 18, 2004
order. On January 14, 2005, the
Department issued an order wherein the Department stated that it lacked
jurisdiction to reconsider its prior order because no protest or appeal was
filed within sixty days.
We
note at the outset that the sixty-day time limit for filing appeals under RCW
51.52.060 begins to run only after the order is communicated. We have held that an order is not properly
communicated to a represented party unless a copy of the order is sent to that
party's representative. In re Bell & Bell Builders (II), BIIA
Dec., 90 5119 (1992); In re David
Herring, BIIA Dec., 57,831 (1981); In
re Better Brashear, Dckt No. 96 3341 (August 8, 1997); and In re Calvin Keller, Dec'd, Dckt. No.
894546 (March 15, 1991). In accordance
with our prior rulings, the sixty‑day period for filing an appeal does
not begin to run until the Department mails the order to the party's
representative. The cases cited herein
did not address the application of the statute upon which the industrial appeals
judge relied in this case.
The
industrial appeals judge relied on RCW 51.04.080 when he dismissed the
claimant's appeal.
[1]
The statute reads:
On all claims under this title, claimants' written
notices, orders, or warrants shall not be forwarded to, or in care of, any
representative of the claimant, but shall be forwarded directly to the claimant
until such time as there has been entered an order on the claim appealable to
the board of industrial insurance appeals.
[3]The
industrial appeals judge interpreted the statute to mean that the first
appealable order issued by the Department must not be forwarded to the
claimant's representative even if the Department has received a notice of
representation, but that the Department must send all subsequent written
communications, including the second appealable order, to the
representative. We disagree with the
industrial appeal judge's interpretation.
The
plain language of the statute refers to an order being entered, as opposed to issued or mailed. We think that the correct interpretation of
the statue requires the Department to mail the first appealable order to a
party's representative, assuming the Department has been notified that the
party is represented. The injured
worker's rights are potentially permanently affected by the entry of an order
appealable to the Board. Once the
injured worker's rights are subject to final determination, the worker is
entitled to representation of his or her choosing. According to our understanding the Department
would enter the appealable order, and then mail it to the claimant and his or
her designated representative. We
believe this interpretation best meets the requirement stated in Clauson v. Department of Labor & Indus., 130 Wn.2d 580 (1996) that, "All doubts as to the meaning of the Act are to
be resolved in favor of the injured worker." Clauson, at 584. The protest
filed by Ms. Miller's representative on November 30, 2004, was a timely protest
of the March 18, 2004 Department order. The Department order dated January 14, 2005, is incorrect and is reversed. The matter is remanded to the Department to
issue a further order regarding the claimant's application to reopen her claim
and to take further action as is appropriate under the law and facts.
FINDINGS OF FACT
1. On May
18, 2000, Pamela K. Miller, the claimant, filed an application with the
Department of Labor and Industries in which she alleged that she was injured on
May 3, 2000, while in the course of her employment with the self‑insured
employer, Tacoma School District #10. On
October 19, 2000, the self-insured employer issued an order wherein it
closed the claim without an award of permanent partial disability benefits.
On
February 6, 2004, the claimant filed an application to reopen her claim. On March 18, 2004, the Department issued an order
wherein it denied the claimant's application to reopen her claim because the
Department found that medical evidence showed that the condition had
[4]not objectively worsened since
final claim closure. On November 30,
2004, Ms. Miller filed a protest to the Department's March 18, 2004 order. On January 14, 2005, the Department issued an
order wherein it stated that the Department was not able to reconsider its
March 18, 2004, order due to lack of jurisdiction because no written protest or
request for reconsideration was received within the statutory time limits. On March 8, 2005, the claimant filed a Notice
of Appeal with the Board of Industrial Insurance Appeals from the Department's
January 14, 2005, order. On March 30,
2005, the Board issued an order granting the appeal under Docket No. 05 12252.
2. On May
3, 2000, the claimant, Pamela K. Miller, suffered an industrial injury while in
the course of her employment with Tacoma School District #10.
3. The
claim was closed on October 19, 2000. On
January 28, 2004, Ms. Miller mailed an Application to Reopen Claim. The Department received the reopening
application on February 6, 2004.
4. On
January 29, 2004, a Notice of Representation was sent by Ms. Miller's
attorney, David B. Vail & Associates, to the Department of Labor and
Industries and to the self-insured employer's third-party administrator, Puget
Sound Workers' Compensation Trust.
5. On
January 30, 2004 and on March 1, 2004, the self-insurance section of the
Department received the Notices of Representation Mr. Vail's office submitted
on behalf of Ms. Miller.
6. On
March 18, 2004, the Department issued an order wherein it denied the reopening
application. The order was mailed to the
claimant's home address, but not to her representative.
7. The
March 18, 2004 order was the first order issued under this claim that was
appealable to the Board of Industrial Insurance Appeals.
8. The
March 18, 2004 order was not properly communicated to Ms. Miller because it was
not sent to her representative.
9. Ms.
Miller did not file a protest or appeal of the March 18, 2004 order until
November 30, 2004.
CONCLUSIONS OF LAW
1. The
Board of Industrial Insurance Appeals has jurisdiction over the parties to and
the subject matter of this appeal.
2. The
Department's March 18, 2004 order was not properly communicated to Ms. Miller
in accordance with RCW 51.52.050 and RCW 51.04.080.
3. Because
the order was not properly communicated, Ms. Miller's November 30, 2004 protest
was timely in accordance with RCW 51.52.060.
[5]4. The
Department order dated January 14, 2005, is incorrect and is reversed. This matter is remanded to the Department to
issue a further order in response to Ms. Miller's November 30, 2004 protest and
to take such further action as is appropriate under the facts and the law.
It is so ORDERED.
Dated this 11th day of January, 2006.
BOARD OF INDUSTRIAL INSURANCE APPEALS
/s/
THOMAS E. EGANChairperson
/s/
FRANK E. FENNERTY, JR.Member
/s/
CALHOUN DICKINSONMember
[1] We note for purposes of clarity that the correct disposition of this case, if we agreed with the industrial appeal judge's decision, would have been to affirm the Department order, rather than to dismiss the appeal. The current posture of the case, however, reflects the dismissal decision issued by the industrial appeals judge.
